title: Imaging in assessing hepatic and peritoneal metastases of gastric cancer: a systematic review.
abstract: BACKGROUND
  Hepatic and peritoneal metastases of gastric cancer are operation contraindications. Systematic review to provide an overview of imaging in predicting the status of liver and peritoneum pre-therapeutically is essential.
  
  
  METHODS
  A systematic review of relevant literatures was performed in Pubmed/Medline, Embase, The Cochrane Library and the China Biological Medicine Databases. QUADAS was used for assessing the methodological quality of included studies and the bivariate model was used for this meta-analysis.
  
  
  RESULTS
  Totally 33 studies were included (8 US studies, 5 EUS studies, 22 CT studies, 2 MRI studies and 5 18F-FDG PET studies) and the methodological quality of included studies was moderate. The result of meta-analysis showed that CT is the most sensitive imaging method [0.74 (95% CI: 0.59-0.85)] with a high rate of specificity [0.99 (95% CI: 0.97-1.00)] in detecting hepatic metastasis, and EUS is the most sensitive imaging modality [0.34 (95% CI: 0.10-0.69) ] with a specificity of 0.96 (95% CI: 0.87-0.99) in detecting peritoneal metastasis. Only two eligible MRI studies were identified and the data were not combined. The two studies found that MRI had both high sensitivity and specificity in detecting liver metastasis.
  
  
  CONCLUSIONS
  US, EUS, CT and 18F-FDG PET did not obtain consistently high sensitivity and specificity in assessing liver and peritoneal metastases of gastric cancer. The value of laparoscopy, PET/CT, DW-MRI, and new PET tracers such as 18F-FLT needs to be studied in future.
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, 6 Shuang Yong Road, Nanning 530021, Guangxi, PR China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Wang
authors.forename: Jun-Qiang
authors.initials: JQ
authors.lastname: Chen
mesh_terms: D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000556:secondary; D008279:Magnetic Resonance Imaging; D010534:Peritoneal Neoplasms / Q000175:diagnosis* / Q000556:secondary; D049268:Positron-Emission Tomography; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography